Dataset Information

ICU-Acquired Pneumonia Is Associated with Poor Health Post-COVID-19 Syndrome.

ABSTRACT:

Background

Some patients previously presenting with COVID-19 have been reported to develop persistent COVID-19 symptoms. While this information has been adequately recognised and extensively published with respect to non-critically ill patients, less is known about the incidence and factors associated with the characteristics of persistent COVID-19. On the other hand, these patients very often have intensive care unit-acquired pneumonia (ICUAP). A second infectious hit after COVID increases the length of ICU stay and mechanical ventilation and could have an influence on poor health post-COVID 19 syndrome in ICU-discharged patients.

Methods

This prospective, multicentre, and observational study was carrid out across 40 selected ICUs in Spain. Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated three months after hospital discharge.

Results

A total of 1255 ICU patients were scheduled to be followed up at 3 months; however, the final cohort comprised 991 (78.9%) patients. A total of 315 patients developed ICUAP (97% of them had ventilated ICUAP). Patients requiring invasive mechanical ventilation had more persistent post-COVID-19 symptoms than those who did not require mechanical ventilation. Female sex, duration of ICU stay, development of ICUAP, and ARDS were independent factors for persistent poor health post-COVID-19.

Conclusions

Persistent post-COVID-19 symptoms occurred in more than two-thirds of patients. Female sex, duration of ICU stay, development of ICUAP, and ARDS all comprised independent factors for persistent poor health post-COVID-19. Prevention of ICUAP could have beneficial effects in poor health post-COVID-19.

SUBMITTER: Martin-Loeches I

PROVIDER: S-EPMC8746263 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Publications

ICU-Acquired Pneumonia Is Associated with Poor Health Post-COVID-19 Syndrome.

Martin-Loeches Ignacio I Motos Anna A Menéndez Rosario R Gabarrús Albert A González Jessica J Fernández-Barat Laia L Ceccato Adrián A Pérez-Arnal Raquel R García-Gasulla Dario D Ferrer Ricard R Riera Jordi J Lorente José Ángel JÁ Peñuelas Óscar Ó Bermejo-Martin Jesús F JF de Gonzalo-Calvo David D Rodríguez Alejandro A Barbé Ferran F Aguilera Luciano L Amaya-Villar Rosario R Barberà Carme C Barberán José J Blandino Ortiz Aaron A Bustamante-Munguira Elena E Caballero Jesús J Carbajales Cristina C Carbonell Nieves N Catalán-González Mercedes M Galbán Cristóbal C Gumucio-Sanguino Víctor D VD de la Torre Maria Del Carmen MDC Díaz Emili E Gallego Elena E García Garmendia José Luis JL Garnacho-Montero José J Gómez José M JM Jorge García Ruth Noemí RN Loza-Vázquez Ana A Marín-Corral Judith J Martínez de la Gándara Amalia A Martínez Varela Ignacio I Lopez Messa Juan J Albaiceta Guillermo M GM Novo Mariana Andrea MA Peñasco Yhivian Y Ricart Pilar P Urrelo-Cerrón Luis L Sánchez-Miralles Angel A Sancho Chinesta Susana S Socias Lorenzo L Solé-Violan Jordi J Tamayo Lomas Luis L Vidal Pablo P Torres Antoni A

Journal of clinical medicine 20211231 1

<h4>Background</h4>Some patients previously presenting with COVID-19 have been reported to develop persistent COVID-19 symptoms. While this information has been adequately recognised and extensively published with respect to non-critically ill patients, less is known about the incidence and factors associated with the characteristics of persistent COVID-19. On the other hand, these patients very often have intensive care unit-acquired pneumonia (ICUAP). A second infectious hit after COVID increa ...[more]

PMID: 35011967

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Project description:BackgroundEarly appropriate antibiotic therapy reduces morbidity and mortality of severe pneumonia. However, the emergence of bacterial resistance requires the earliest use of antibiotics with the narrowest possible spectrum. The Unyvero Hospitalized Pneumonia (HPN, Curetis) test is a multiplex PCR (M-PCR) system detecting 21 bacteria and 19 resistance genes on respiratory samples within 5 h. We assessed the performance and the potential impact of the M-PCR on the antibiotic therapy of ICU patients.MethodsIn this prospective study, we performed a M-PCR on bronchoalveolar lavage (BAL) or plugged telescoping catheter (PTC) samples of patients with ventilated HAP or VAP with Gram-negative bacilli or clustered Gram-positive cocci. This study was conducted in 3 ICUs in a French academic hospital: the medical and infectious diseases ICU, the surgical ICU, and the cardio-surgical ICU. A multidisciplinary expert panel simulated the antibiotic changes they would have made if the M-PCR results had been available.ResultsWe analyzed 95 clinical samples of ventilated HAP or VAP (72 BAL and 23 PTC) from 85 patients (62 males, median age 64 years). The median turnaround time of the M-PCR was 4.6 h (IQR 4.4-5). A total of 90/112 bacteria were detected by the M-PCR system with a global sensitivity of 80% (95% CI, 73-88%) and specificity of 99% (95% CI 99-100). The sensitivity was better for Gram-negative bacteria (90%) than for Gram-positive cocci (62%) (p = 0.005). Moreover, 5/8 extended-spectrum beta-lactamases (CTX-M gene) and 4/4 carbapenemases genes (3 NDM, one oxa-48) were detected. The M-PCR could have led to the earlier initiation of an effective antibiotic in 20/95 patients (21%) and to early de-escalation in 37 patients (39%) but could also have led to one (1%) inadequate antimicrobial therapy. Among 17 empiric antibiotic treatments with carbapenems, 10 could have been de-escalated in the following hours according to the M-PCR results. The M-PCR also led to 2 unexpected diagnosis of severe legionellosis confirmed by culture methods.ConclusionsOur results suggest that the use of a M-PCR system for respiratory samples of patients with VAP and ventilated HAP could improve empirical antimicrobial therapy and reduce the use of broad-spectrum antibiotics.

Dataset Information

ICU-Acquired Pneumonia Is Associated with Poor Health Post-COVID-19 Syndrome.

Background

Methods

Results

Conclusions

Publications

ICU-Acquired Pneumonia Is Associated with Poor Health Post-COVID-19 Syndrome.

Similar Datasets

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